Thursday, March 3, 2011

Dear Dr. Jill on Bullying

Dear Dr. Jill:

It seems that teasing and ridicule have become the norm for both fourth and fifth grade students.  I don’t want my daughter to participate in hurting other students or be hurt herself.  What can I do?

Yours truly, Concerned

Dear Concerned:

I sure remember a certain amount of teasing and “picking on” that went on when I was in school, but I recall most of it started in Middle School, not Elementary!   While it seems adults of every generation  have shaken their heads and muttered, “What is wrong these kids today?”, children today live in a fast paced world with  stresses most of us couldn’t even imagine when we were young.  Children are exposed to complex adult behavior (and misbehavior) at younger ages than ever before.  Politeness, respect for authority or expertise, and good manners are not particularly encouraged in today’s culture.  Often children are permitted to be inappropriate with adults because they are considered to be equal to adults in their rights, preferences and opinions.  Unfortunately, as the teasing and ridicule demonstrates, children generally lack the judgment for this much democracy.  Children copy what they see.  When TV, movies, and video games consistantly portray sarcastic, rude, and mean interactions, children learn this as the norm.  Children generally don’t engage in unstructured play anymore.  Much of this street and playground activity provided a natural classroom for peer relations (not that it wasn’t sometimes painful…) that today’s children cannot learn from.

This insight is helpful, but it doesn’t suggest much that we can do immediately.  Solutions can include:

Talk to the principal, school counselor, and your children’s teacher about the “social environment” in the school and your child’s classroom.  While many schools provide instruction about values and interpersonal skills, they often move on to another module and never follow up or put into practice what they have taught.  Appropriate behavior is not a one shot deal, continuous attention, correction and feedback are necessary to make such behaviors routine.  Ask the teacher to to do what he can to create and atmosphere of mutual respect and kindness in your child’s classroom.If you are unhappy with the social environment encouraged or reinforced by the authority figures in the school make your displeasure known.

What kind of a role model do you want to be?  If you speak in a sarcastic or contemptuous voice, expect no different from your kids.  If you tease them, they will tease others.  If you ridicule them, ridiculing others will be natural to them.  If you are disrespectful and unkind, the apple will not fall from the tree.  If you cannot control this behavior in yourself and you are the “grown-up”, how can you expect something better from your child?  If you are out of control, individual or family psychotherapy may be necessary.

Discuss and role play appropriate behaviors.  Point out example s of the right way you want things done.  For example, you might say, “Suzie was very polite when she came to borrow that egg for her Mom, don’t you think so.”  Or, “One of my customers was so nasty to me.  This is what he did … and I felt so hurt!  I would never treat anyone like that.”  Also, “Good job, you played nicely with Ethan and shared your toys.  I know he’s looking forward to having you come play at his house.” Comment on your child’s tone of voice.  Give them feedback on how you perceive them.  Children are not good at seeing themselves from another’s perspective.  They often think they are being clever and funny.  When they find out their behavior is hurtful or mean, many kids are horrified.  Talk to children about why kindness matters and how it works in the long run.  Ask them to consider the long -term consequences of mistreating others (for ex: no one will invite you to their parties).

Read books and see movies together where the characters are kind and considerate.  Be careful about the video games you buy for your kids or let them play.  Strike up conversations with your children about the characters and what’s “cool”.  Teach your children to admire characters who are smart (like Harry Potter) rather than the nasty ones, like (iforgothis namethe blomdboyfrom slytherin).  Ask them how they feel about seeing others, even if its just “virtual” “being treated badly.  Virtual violence can damage perspective as much as “real” violence.

In addition to teaching “Just say no!’ to drugs, we also need to teach “Just say no!” to nasty behavior.   Consider alternative ways for children to get others to notice and like them.  Teach them to stand straight, look teasing/ ridiculing kids in the eye, and tell them assertively that they are being mean.

The best way to make your child part of the solution rather than part of the problem is to make kindness, consideration and respect a part of their daily lives.  Children learn what they live.  Teach them well.

Dear Dr. Jill on Summer Vacation

Originally published in Oak Meadow Elementary School Hoofprints Newsletter April 2004

Dear Mommy (even if everyone else calls you Dr. Jill),

How can we have the best summer ever?

Love Greg, Bradley & Nikki
My dearest children,

First I will tell you why we have such a long summer vacation.  In the olden days, back when your great-great grandparents were children, most people lived on farms.  Farm families had LOTS of children because more children meant more help on the farm.  Everybody knew school was important, but taking care of and harvesting the crops was even more important.  They couldn’t just go down to the grocery store for their food, so if they didn’t take care of the farm, they would be hungry.  For this reason, children didn’t go to school during the summer because this was the time they were needed to work on the farm.  Not much of a vacation, was it?

Children today have lots of time off during the summer and usually there are no crops to care for.    I want to get together one night, make some popcorn, and find out what everybody in our family likes doing best.  To have the best summer ever, we need to spend lots of time doing the things we like best.  I know we will want to do lots of swimming and bike riding.  Lets plan on some lazy breakfasts where we all help make the pancakes or eggs. I think this might be a good summer for you kids to learn some cooking.  Lets take the time to learn to bake a cake and make grilled cheese sandwiches.  Yum yum!  Spending time with friends sounds great too.  Sometimes your friends can come to our house.  Remember they must follow our rules about inside voices, walking instead of running, listening, sharing and keeping hands to selves.  Other times you can go to their houses to play.  Behave well and win the good guest medal by being invited back!  I think the best times are when you go outside and you run, feel the wind, giggle, roll in the grass, get sweaty and hot, and then drink something cold or have a popsicle.  Playing with the hose or in the pool are special summer treats too.

We are planning two very special vacations this summer.  We will go to Disneyworld and to the beach at South Padre Island.  We will spend lots of good times together.  At Disneyworld  we get to go on rides, eat interesting food, ride trams and see things we’ve never seen before.  We will take an airplane and stay in a hotel so we must remember to be respectful, polite and kind.  I will pack bags with treats and activities to keep you busy.  Traveling is a great time for gameboys, coloring or reading books.  When we go to the beach, we will drive.  Lets have a nice time in the car.  We can sing and talk and listen to music or books on tape. Looking at the scenery, animals, clouds, plants, houses and train tracks can pass the time quickly.  At the beach, you have to remember to always wear sun screen and stay where an adult can see you.  Don’t go in the water without permission! We will eat in lots of restaurants on both trips.  Talk in a calm, inside voice.  Order only what you plan to eat.  Sometimes we will get dessert but not every day so please don’t complain.  Complaints are never welcome, although suggestions usually are. 

Summer vacation is a long time away from school.  It is easy to forget the things you worked so hard to learn this year.  A good way to stay smart is to read.  We will try to read at least 30 minutes every day.  You are all good readers so I bet there will be many days you will want to read even more than that.  We can go to the library or bookstore to pick out some interesting books. We can play math games in the car or at dinner.  You can go to the store with me and help me pick out what we need and figure out what we are spending.  Computer math games are a good way to stay smart too.

Remember when I told you about the farm children earlier?  Summer vacation can be a good time to learn new skills and chores.  We all enjoy living in the house together so we all must pitch in and do our part.  Lets talk about chores AND allowances.  Its nice to have pocket money to buy what you want and to learn about responsible spending.  

The most important way to have the best summer ever is to enjoy time as a family and time by your self.  We have the most fun when we are kind and considerate and generous with each other.  We are happiest when we take turns and practice patience.  At night, we can sit outside and watch the stars and moon.  Maybe we will see constellations or planets.  Sometimes we can catch fireflies but we must always let them free before we go inside.  I also like to watch our pets playing.  It is so relaxing!  Our dog does funny things that make us laugh.  Our cats are so cute together and love to be petted gently.  We should spend time outside watching the clouds, blowing bubbles, playing games and walking in the woods.  Maybe we can go through some old photos together and talk about your grandparents and what life was like when Mommy and Daddy were your age. Quiet time spent thinking about our love for each other, what we are grateful for and how to be the best we can be is a good way to spend hot afternoons.  Its so easy to forget how nice it can be to do nothing.

Sounds like a good plan for the best summer ever doesn’t it?  I can’t wait!  

Follow me on Facebook 

Dear Dr. Jill on Work/Family Balance

Dear Dr. Jill:

My husband and I both work and sometimes it feels like our children are raising themselves!  We need both of our jobs to meet our budget.  We also enjoy our work and find it to be very meaningful.  What can we do to be more involved and connected with our kids?

Welcome to family life in the new millennium!  Balancing work and family has always taken love, creativity and stamina.  Throughout history, parents have worked and had to do their parenting AROUND their work.  Dad didn’t delay harvesting the wheat because Junior had a spelling test the next day.  Mom baked today’s bread even when she had a sick child to tend.  Traditionally, the ability to devote one’s self full time to parenting has been a luxury most parents couldn’t afford.  The great mid-century post-war prosperity allowed many (but not most) families this luxury.  Today, many working parents experience considerable guilt because their children are deprived of the idealized family life of the 1950’s.   The good news is that you can be involved and connected with your kids by combining both “quality” time and “quantity” time as your situation permits.  Here are some ideas:

1.    Make family a priority. Schedule consistent weekend time as a family. Family vacations and regular family activities will enhance family connection.  Reconsider your volunteer work and civic contributions.  Would it be best to spend more time with your kids now and more time on these other important pursuits later?  Plan time with extended family.  Keep family pictures around where kids can see them. 
2.    Focus less on individual activities and more on family activities. Minimize separate after school sports, clubs and activities.  Have everyone take an art class this summer and try basketball together next fall.
3.    Talk to your kids about your work.  Make sure they know what you do.  Share what is meaningful about your career with your family.  Take your children to your office.  Have them sit in your chair. Show them their pictures on your desk or their artwork on you bulletin board. 
4.    Enjoy meals together.  Plan at least 3 leisurely meals together per week.  TURN OFF THE TV!  Make conversation and listen to each other.
5.    Watch movies, read books (aloud!) and play games that celebrate family and encourage interaction.
6.    Develop family rituals and traditions.
7.    Become the family your children’s friends want to hang out with.
8.    Involve your children in caring for their own home and family.  Give them chores that can be done along with other family members (such as weeding, washing dishes, cooking) rather than solitary activities like taking out the trash.. In the past, shared chores were an important part of parent-child interaction, as well as the only way to get things done before modern conveniences.
9.    Promote a family friendly workplace.  If you are in a management position, allow your employees the flexibility to attend school functions, prepare for important holidays, vacation during school breaks, and work at home when necessary. Remind each other that you work to live, not live to work.  No one uses their last breath to wish they had worked more.  Vote for politicians who promote life balance and family rights.
10. Involve yourself in what’s important to your child, especially school and school projects.  Include your child in activities that are important to you.

Dear Dr. Jill on Homework

Dear Dr. Jill:

My eight-year-old son is now in third grade.  He is getting a lot more homework this year than ever before.  Getting his homework done is a real problem.  He makes up all kinds of excuses, “forgets” that he has homework or waits until it is bedtime to even start his assignments.  We never had this problem with his older brother and we are at our wit’s end.  Please help!

Harried Homework Mom

Dear Harried Homework Mom:

As I am sure you already know, all children are different.  Therefore something that comes easily to your first child will not necessarily come easily to your second one.  First of all I have some great news.  Your child’s homework is his assignment, not yours!  This is good news because it frees you from homework-related anxiety and guilt.  Unless you plan to go to college with your son, he MUST learn to do his own homework.  Of course, this doesn’t mean you ignore his needs, it simply means that clarifying what is YOUR job and what is HIS job, can bring your homework-related stress level way down.  HIS job is to actually get the homework done.  HIS job is to learn the material the homework was assigned to teach or reinforce.  It is not YOUR job to do the homework for him (I once thought I was working on a diorama WITH one of my sons.  After it was done, I realized that I had somehow done all of the work while my son looked on admiringly.  What a clever boy!  His teacher sent home a note to let me know that the project was very well done and that “I” had received an “A”.  I never did another one of his assignments all by myself again.) 

It is not YOUR job to make sure his homework is the best in the class.  It is not YOUR job to show everyone how smart you are through his homework.  It is not YOUR job to demonstrate how cutting edge your computer equipment is or how amazing your artistic abilities are.  It is definitely not YOUR job to allow getting homework done to be a battleground that ruins your evenings and interferes with the quality of your relationship with your son.

So then, what is YOUR job?  Your job is to create an appropriate opportunity for homework to be done and to offer your son the guidance necessary to understand and complete the work.  The goal is for your child to learn how to bring home his assignment, figure out what must be done and do it according to his own skill level before bedtime.  An important puzzle piece we often forget is that it is also HIS job to develop good study habits as early in his academic career as possible. 

Your first step can be having a heart-to-heart talk with your son.  When you are both in a reasonably good mood, find someplace quiet where the two of you can talk.  Perhaps, you can take him out for ice cream, just the two of you. Tell him you don’t like the way the homework problem is affecting your relationship with him.  Ask him to share how he sees the problem.  You will likely be surprised how your perceptions and his differ.  Explain what YOUR job is and what HIS job is as described above.  Ask him for ideas about how you can get your job done and he can get his job done.  It is thrilling to discover how often children know exactly what they need when you ask them.  Gently offer your concerns, feedback and suggestions. The next day, put the plan into action.  Let him know that this is a work in progress and that you will revisit the issue in the next week or two.  From that point on, only assume responsibility for the part of the job that is YOURS.  If his plan doesn’t work, ALLOW natural consequences to take their toll.  If he “forgets” his homework, let him get a zero (a few zeros on third grade will not reduce his chances of getting into Harvard in ten years).  If he asks to stay up late because he didn’t start his homework at the agreed upon time, don’t let him stay up.  Be flexible if your own time constraints or family activities interfere with getting the homework done according to plan.  Inform the teacher, but don’t write notes explaining why his homework is incomplete or undone.  Do not nag or hassle him. If the homework is still not getting done properly in a week or two, THEN feel free to offer some new ideas. 

The good thing about being the parent is that you can set rules and expect them to be followed.  However, bear in mind what you can and can’t control before setting any rules.  You cannot MAKE him do his homework.  You can offer a quiet place to do so and you can insure that the TV is off (I know one Mom who had to physically remove the TV to keep her son from turning it back on).  You can tell him he must sit at his desk quietly for 30 minutes so he has the opportunity to do his homework but you cannot actually make him apply himself to the homework.  Tell him you are happy to help him understand the assignment or the concept but you will not do the whole assignment for him.  It is OK, however, to talk him through a problem or two if he needs some help him figuring out what needs to be done. 

If you are still having difficulty, you can try a star chart or reward system to encourage completion of homework.  Only use small rewards, such as more desert or an extra 15 minutes before lights out. Do not offer money.  If you offer big rewards for completing 30 minutes of homework in third grade, what will you need to offer when he is in 10th?  Limiting video games or TV until after homework is done usually works very well too.  Remember, your goal is to encourage intrinsic motivation to do his homework and develop good study skills.

When he is doing his homework regularly and independently, make sure to congratulate him.  You might consider taking him out for ice cream again, but this time it will be just for fun.  

Jill Squyres, Ph.D. is a clinical psychologist in private practice.  

My Turn 2007

My Turn
And Who Should Bear the Cost?
Jill Squyres, PhD

As a teenager growing up in the post Viet Nam era, I have to admit my opinion of veterans was less than flattering.  When I was offered a research job at a prestigious VA Hospital when I was 22, I was excited by the research opportunity but chagrined that I would be working at a VA Hospital.  However, I was favorably impressed by my experience.  I grew to have a deep respect for what veterans had done for my freedom and the way of life I valued.   I went on to do my clinical psychology internship at another VA hospital several years later and discovered I really enjoyed working with vets.  In 1991, I was hired as a staff psychologist at the VA Hospital in San Antonio Texas.   I resigned in frustration in 2002 and I am now in private practice.  I take many different insurance plans in my practice, but I am proud to continue serving veterans and their families as a Tricare provider.  I was shocked and dismayed to receive a letter two weeks ago informing me that my Tricare reimbursement rate, already one of the lowest among all managed care plans, was being reduced.  How could they be offering to pay me less to treat veterans and their families when the need for psychological services was going up?  It didn’t make sense.

I have been watching the recent news about veteran’s services with interest and frustration.  When I started out at the VAMC in San Antonio, I was proud of the excellent care we provided to our patients.  We were appropriately staffed with caring employees and well-credentialed professionals.  Then the budget cuts began.  The number of veterans needing services increased.  Our documentation requirements were raised.  Standards of care became more rigorous.  In most settings, the logical response would have been to hire more staff to meet increased demand.  Instead, my job was put on a list to be RIF-ed.  The RIF  (Reduction in Force) list was based solely on longevity as a civil service employee.  I was explicitly told that the quality of my work, my credentials, and my expertise in my job were irrelevant.  Eventually the RIF list was quietly withdrawn.  The budget was balanced by instituting a hiring freeze accompanied by natural employee attrition.  Unfortunately, this increased the pressure to do more with less and spread fear among us that one of our coworkers might choose to retire and leave us with twice as much work to do with 100% less help.

General dissatisfaction and complaints escalated.  Wait times increased dramatically.  Staff members quit and were not replaced.  Some patients started hiring their own caregivers to stay with them at the hospital because the nursing staff was overworked and did not respond to their calls.  The Spinal Cord Injury unit where I worked allowed family members to spend more and more time with their loved ones, otherwise paralyzed patients might not have anyone to help them eat or provide basic personal care.

We were strongly encouraged to reduce visit length and raise the number of patients seen each week.  While enhanced efficiency is both responsible and desirable, increasing “numbers” at the expense of effectiveness is not.  We were required to do our work with little to no administrative support.  I would type my own forms and run any copies I needed, while still being expected to see more patients every day.  There was no one to delegate administrative tasks to since much of that staff had already been downsized.  I became very proficient at fixing the copy machine, an absurd task for a psychologist but a necessary one when I had a psychotherapy group waiting for handouts and no copies to give them.

My salary and benefits were good.  I was doing meaningful work for patients who deserved the best medical care available.  I was part of a great team of caring professionals.  However, all the fat in the system was trimmed and we were well into the lean muscle.  Without appropriate funding, even the most caring and capable professionals cannot provide quality services.  Administrators can’t allocate money they don’t have in their budgets.  Is it prudent for those in charge to dissemble when the truth is discouraged?  My decision to resign was difficult but also prudent.

Private practice is not easy.  Managed care can be frustrating.  I can no longer treat patients without concern for their ability to pay.  I miss that flexibility but it is a business reality.  We can blame whomever we want for the troubles at Walter Reed and the VA but we, the public, need to hold up a mirror and reconsider our priorities.  We cannot afford peace at any price.  Our veterans should not continue to bear the cost of our freedom with frustration and substandard care.   If we can find money for bombs, why can’t we find money to care for our vets after they come home?  The cost of a war includes bearing the cost of care to veterans and their families.  In 1865, Abraham Lincoln promised that our country would “care for him who shall have borne the battle and his widow and his orphan”.   It is my fervent hope that we decide this still holds true

Bibliotherapy and Beyond 06/2008: Memoirs

The summer reading season is upon us!  How delightful it is to lounge on a warm Sunday afternoon sipping a cold glass of iced tea while savoring a good book.  I always try to save my best reads for the summer because somehow summer reading is the best of all.  Most of us are so chronically busy these days that relaxing with a good book on Sunday afternoon may seem like too much of a frivolous luxury to indulge in.  After all, there are so many other more constructive things we should be doing, right?  Wrong!  First of all, we must practice what we preach.  If we preach balance to our clients, we must practice balance ourselves.  So a little indulgence becomes self-care, which is professionally responsible.  Second, if you read the books I recommend in this column you get to enjoy yourself, relax AND get some work done.  That’s a win-win all around.

This month, I am focusing on memoirs.  Memoirs are huge assets in our work as psychotherapists.  They can be as engrossing as novels but they have much more credibility.  After all, what better way to learn than to hear about it from someone who has actually been there and prevailed in a way that is interesting enough to publish?  Its far more efficient and enjoyable than actually having to go through the experiences ourselves!  There are so many great memoirs out there so it was hard to winnow down my list but upon reflection, these are my top three:

I Know Why the Caged Bird Sings by Maya Angelou (1969)
Maya Angelou is an amazing person and she seems even more amazing after you read her memoir.  Ms. Angelou is an African American poet who has inspired many women, including Oprah, to rise above oppression.  Considering all she’s been through, we would completely understand it if she spent the rest of her life curled up in the corner in a fetal position in a Seroquel haze instead of writing prize winning poetry.  The book is beautifully written.  Although some of her experiences are truly horrifying, the lovely prose keeps you reading.  She writes about victimization and helplessness with journalistic precision paired with compassion and hard-earned wisdom.  Reading this book is an enjoyable, engrossing and inspiring experience.

The Glass Castle by Jeanette Wells (2005)
This New York Times bestseller is one of the starkest dysfunctional family dramas I’ve ever read (and I’ve read a LOT of them).  Both of the author’s parents drag their four kids through the horrors of their mental illnesses. Depending on their parents’ folie de jour the children alternate between feeling neglected or abused and believing they are the luckiest, most special, cherished children on earth.   Their father is a master spinner of tales paired with misguided genius and unrequited dreams.  He is never formally diagnosed but symptoms of narcissism, antisocial personality, paranoid delusions, psychosis, bipolar disorder and alcoholism are evident.  Their mother is depressed, dependent, histrionic and ineffectual (borderline comes to mind).  One sister ends up schizophrenic but the other three children demonstrate a resilience that is remarkable to behold.  This book demonstrates that all children from dysfunctional households do not have to end up dysfunctional themselves.  The author’s compassionate but unflinching consideration of her complex, chaotic and heartbreaking childhood raises fascinating questions about the varying roles of adversity, resilience, love and redemption in personality development.          

Divided Minds by Pamela Spiro Wagner and Carolyn S. Spiro, M.D. (2005)
What is it really like to be schizophrenic?  How can we even begin to imagine the chaos in the mind of someone who is psychotic?  If you want to know, read this book.  Divided Minds chronicles the lives of a pair of identical twins raised in an upper middle class family in Connecticut from their earliest memories (in the 1950’s) to the present.  One twin, Pam has chronic paranoid schizophrenia and the other twin, Carolyn, is a psychiatrist (I know, I know, hold the jokes please!).  The twins, who are now in their 50s, wrote the book together, primarily during the psychotic twin’s more lucid (aka well-medicated) moments.  For the researchers among us, please note that this pair of twins represents one of the most fascinating natural experiments in the etiology of schizophrenia to date. This illuminating and compellingly readable book will forever change your understanding of psychosis.  

Bibliotherapy and Beyond 12/2008: Coping With Financial Problems

I don’t know about you, dear reader, but my personal and professional life has been deeply affected by the recent economic downturn and I imagine in some way, yours has too.  So rather than discuss the holidays like everyone else at this time of year, I thought I would write about books that will enhance our personal and psychological understanding of money, finance and the economy.

I’ve always had an interest in economics, probably because I love math and statistics.  My work-study job in college was in the university’s general accounting office, which piqued my interest and taught me a thing or two about accounting and finance.  As psychologists, we don’t need to be financial wizards (although it helps if you have a practice or a research grant or run a department).  However, we do need to understand the emotional issues that revolve around money in our client’s lives and how macroeconomic issues impact people at the individual level.  And of course, a basic understanding of budgeting, investing, credit, loans and financial decision-making can enhance our effectiveness (not to mention our bottom lines) across the board.

I’ve always taken issue with the ‘personal self-discipline and will power conquers all’ approach to money management.  It seems overly simplistic and unrealistic given what we know about human nature.  So, I was delighted to find a book called “ Going Broke: Why Americans Can’t Hold On To Their Money” (2008) by Stuart Vyse Ph.D.  Dr. Vyse is an academic psychologist who expertly integrates the cognitive, social-psychological and behavioral neuroscience literature to explain in a highly readable manner why so many of us are going broke.  It’s a fascinating and engaging book that makes some excellent practical suggestions for overcoming the natural psychological obstacles to responsible money management.

Of course, graduate school didn’t teach us anything about budgeting, credit or finance.  For that matter, neither did college or high school.  Most of our parents didn’t discuss these topics beyond giving us an allowance, a piggy bank and perhaps, if we were really lucky, a savings account.  If you want a good understanding of basic money management, you can’t beat Dave Ramsey.  He’s written several great books but his most popular book “The Total Money Makeover: A Proven Plan for Financial Fitness” (2007), is a gem.  He also has a cable TV show if you want to learn more beyond the book or you want to recommend his system to clients or friends who don’t like to read.  Suze Orman writes for O magazine, appears on Oprah’s show and also has her own cable TV show.  Her 2006 book, “The 9 Steps to Financial Freedom” is wonderful.  Her most recent book “Women and Money: Owning the Power to Control Your Destiny” (2007) addresses the unique concerns many woman have about effective money management.  Another book of particular interest to women is “Money: A Memoir: Women, Emotions, and Cash” (2006) by Liz Perle.  It’s the only book I’ve found that offers an unflinching account of a personal journey through the emotional minefield of unexamined financial issues.

If you are interested in taking on the task of making sense (cents) out of the breakdown of the economy, I have some suggestions.  “Conspiracy of Fools: A True Story” (2005) by Kurt Eichenwald is a chilling documentary about the Enron disaster.  If you want to understand how narcisstic personality disorder can bring down an entire corporation (not to mention the national energy market), read it and weep.  “The Trillion Dollar Meltdown: Easy Money, High Rollers, and the Great Credit Crash” (2008) by Charles Morris explains contemporary macroeconomics.  It’s a complex topic but the book is packed with lucid information about the evolution of our economy with particular emphasis on the current credit crisis.  A somewhat more accessible book on this topic is “Bad Money: Reckless Finance, Failed Politics, and the Global Crisis of American Capitalism by Kevin Phillips (2008).  His earlier book “American Theocracy” is also illuminating and provocative.

If your clients (or you for that matter) are having credit problems, you will find “Solve Your Money Troubles: Get Debt Collectors Off Your Back and Regain Financial Freedom” (2008) by Robin Leonard a helpful read.  It’s in its eleventh edition so it must be pretty good.  This book is published by Nolo Press, which specializes in do-it-yourself legal assistance.  If you or someone you care about finds yourself considering bankruptcy, “The New Bankruptcy: Will It Work For You?” (2007) by Stephen Elias is a practical guide to a scary topic most of us would prefer never to think about.

Most of these books are also available as audiobooks on CD or MP3 downloads.  I particularly enjoy listening to nonfiction on the CD player in my car or on my iPod while I do housework or gardening.   I also listen to books on my iPod while I bike or walk.  I get to exercise my body AND my mind at the same time.  What a deal!  Whatever your favorite approach to nonfiction might be, I hope you find some of these books helpful and interesting.  Until next time, happy reading!  

BCPA (Bexar County Psychological Association) Jeopardy

BCPA Jeopardy 11/7/08

Answer:  Poonam Sharma, Tova Rubin, Melissa Graham
Question:  Name three past presidents of BCPA

Answer: Alex, Bradley, Caleb, Colin, Ian, Greg, Nikki
Question: Name all the EC’s kids under the age of 18

Answer: Private practice, Audie Murphy VA and Wilford Hall
Question: Where do members of the EC practice?

CATEGORY: Psychology in SA
Answer: SAPA or ASAP
Question: Name two acronyms we considered in our ill-fated attempt to rename BCPA so it would be easy to find when searching using the keywords San Antonio.

Answer: Just under one page
Question:  How many psychologists are listed in the Greater San Antonio Yellow Pages under the heading Psychologists?

Answer: Water Street Oyster Bar, The Hungry Horse Restaurant and the Conference Room at Oak Ridge Square
Question: Name 3 places where BCPA’s monthly continuing ED seminars are held.

CATEGORY: Psychology as a Profession
Answer: Almost $500 per year, Almost $300 per year, exactly $60
Question: What is the cost of annual membership in APA, TPA and BCPA?

Answer: 12
Question: How many CEUs are needed annually for license renewal in Texas but also, how many CEUs can you get if you attend BCPA’s Spring and Fall Workshops?

Answer: $95,000 vs $53,000
Question:  Median annual income for a psychologist in Texas according to APA’s 2007 salary survey, vs median annual income for a psychologist in Texas according to the US Dept of Labor’s 2007 salary survey.  More specifically, what is the median income for psychologists in independent practice in the South West Central United States based on only 69 data points and the median number of years in independent practice was 25 vs the US Dept of Labors Office of Employment Statistics 2007 salary survey based on 4390 Clinical Counseling and School Psychologists in the state of Texas.

Bibliotherapy and Beyond 06/2009: Healthy Relationships

At the close of our Spring Workshop, we circulated a survey asking members opinions about topics of interest for future workshops.  The most popular choice by a wide margin was marital therapy.  In the interest of meeting the needs of the membership combined with the fact that June is the most popular month for weddings, the topic for this Bibliotherapy and Beyond article is marital therapy.
The two “grand masters” of marital therapy are Harville Hendrix, PhD and John Gottman, PhD.  Both have published many books on why we choose the partners we do, how to have good long lasting relationships and how to get through relationship rough spots and emerge with greater intimacy.  We are very excited that Dr. Hendrix will be the speaker for our Spring 2010 BCPA Workshop!  Dr. Hendrix’ 2 most popular books are “Getting the Love You Want” and “Keeping the Love You Find.”  His books discuss the psychological and emotional reasons why we fall in love with the people we do and how this knowledge can help us heal our emotional wounds and build successful intimate relationships.  His books are insightful and thought provoking.   Dr. Gottman’s approach to successful relationships is more cognitive-behavioral.  His work focuses on a research informed approach to successful marriage.  His book “Why Marriages Succeed or Fail” was one of the first books ever recommended to me about marital therapy.  It is still one of my favorites.  In this book, he describes the “Four Horseman of the Marital Apocalypse” which defines the negative cascade that leads to the collapse of a relationship.  His more recent book, “7 Principles For Making Marriage Work”, provides clear cut guidelines for enhancing problem solving and communication.
Dr. Pat Love’s books provide a different “angle” on relationships.  Her specialty is the neurochemical basis of attraction and how it affects relationship success.  Two of her best books are “Hot Monogamy” and “The Truth About Love: The Highs, The Lows and How You Can Make it Last Forever.”  Her books are interesting, practical and informative and yes, her last name really is “Love!”   There are many authors who discuss marriage and relationships from an attachment perspective.  Of these, my current favorite is Dr. Sue Johnson.  Her recent book, “Hold Me Tight: Seven Conversations For a Lifetime of Love”, is a highly readable discussion of  the neurobiology of attachment and how our early attachment experiences influence our romantic relationships.  I just finished a fascinating book by Bonnie Weil, Ph.D. called “Financial Infidelity: Seven Steps to Conquering the #1 Relationship Wrecker.”  In this book, which was just published in March 2009, Dr. Weil uses attachment theory as a basis for understanding financial conflict in couples.  She outlines many practical strategies for managing financial disagreements and how the trust, compassion and cooperation that comes with successful money management can be the foundation for a lasting, satisfying marriage.
            I tried to find some memoirs about marriage with little success.  The best was written by Diane Rehm (of National Public Radio) and her husband John Rehm.  Their book, “On Commitment” is a very frank and open dialogue about their struggle to create a lasting supportive marriage.  I applaud them both for the unflinching honesty and willingness to share their journey with the hope of helping others navigate this treacherous territory that characterizes this wise little book.  I actually keep a copy of this in my waiting room! 
I think novels and movies give us some of the best (and most pleasurable) opportunities to gain an in depth understanding of the vicissitudes of marriage.  Unfortunately, there really aren’t too many movies that provide a meaningful window into the intimate realm of marriage.  Some of my top pics are “The Four Seasons”, “Jerry McQuire”, “Shadowlands”, and “The Bridges of Madison County.”  “I Capture the Castle” is excellent in both the book and movie versions.   Sue Miller is my favorite novelist for an insightful exploration of the emotional landscape of married life.  Her most recent book, “The Senator’s Wife” was a wonderful read.  In my opinion, two of her older books, “The World Below” and “Family Pictures” are her best.  A few recent books I’ve particularly enjoyed, as have the clients I’ve suggested them to, are: “The Time Traveler’s Wife”, by Audrey Niffenegger (which is soon to be released as a major motion picture… I can’t wait!) and “The Memory Keeper’s Daughter” by Kim Edwards.  Put them both on your summer reading list if you have the time, they are worth it!

DSM-IV Music Awards

At the Bexar County Psychological Association Fall Social we usually do something funny, sort of skit like.  Last year I put together a BCPA Jeopardy game, which went over well.  After Dr. Susan Wynne  got me in a musical frame of mind, I decided to do something more musical and came up with the idea of the DSM-IV Music Awards modeled on the Academy Awards.  What I thought I would do is announce the category, which would be a DSM-IV diagnosis (or V code) and then 3 or 4 songs that reflect that category and then give a winner for each category.  I thought I would choose the songs and winner for each category with input from everyone on this email.  Suggestions for additional songs and categories are welcome.  If any of you would like to send it on to some others who’s opinions would be helpful, feel free.

The 2009 DSM-IV Musical Awards

Borderline Personality Disorder

Isn’t life Strange by Jim Morrison
Cecilia by Simon and Garfunkel
Heart of Glass by Blondie
Maneater by Hall and Oats
Dazed and Confused by Led Zeppelin
Head Games by Foreigner
Karma Chameleon by The Culture Club
Barracuda by Heart
Addicted to Love by Robert Palmer

AntiSocial Personality Disorder

Bohemian Rhapsody by Queen
Dirty Deeds Done Dirt Cheap by ACDC
Sympathy For the Devil by the Rolling Stones
Thriller by Michael Jackson
Master of the House from Les Miserables

Dependent Personality Disorder

Bridge Over Troubled Water by Simon and Garfunkel
Total Eclipse of the Heart by Bonnie Tyler
Everything I do, I do it for you by Bryan Adams
Hopelessly Devoted to You by Olivia Newton John
You’ve Got a Friend by Carol King
I’ll be there by the Jackson 5
Follow You / Follow Me by Genesis

Narcissistic Personality Disorder

Your So Vain by Carly Simon
Under My Thumb by the Rolling Stones
Someone Saved my Life Tonight by Elton John
Wrapped Around my finger by the Police
Don’t You Want Me by the Human League
Fame by Irene Cara

Major Depressive Disorder

I am a Rock by Simon and Garfunkel
The Sound of Silence by Simon and Garfunkel
At Seventeen by Janis Ian
Jagged Little Pill by Alanis Morisette
King of Pain by the Police
Life is a Lemon and I Want My Money Back by Meatloaf
Dust in the Wind by Kansas


Feeling Groovy by Simon and Garfunkel
Wake Me Up Before You Go Go by Wham
Life in the Fast Lane by the Eagles
Free Falling by Tom Petty
I’m so Excited by the Pointer sisters


Comfortably Numb by Pink Floyd
Brain Damage by Pink Floyd
Psychobabble by the Alan Parsons Project
Excitable Boy by Warren Zevon
Yellow Submarine by the Beatles
These Dreams by Heart

Substance Abuse

Italian Restaurant by Billy Joel
Cocaine by Eric Clapton
Tequila Sunrise by the Eagles
Margaritaville by Jimmy Buffet
White Rabbit by Jefferson Airplane
Lucy in the Sky with Diamonds by the Beatles

Obssessive Compulsive Disorder

Pyramania by the Alan Parsons Project
Money by Pink Floyd
You Aughtta Know by Alanis Morisette
I’m In Love With My Car by Queen
Pinball Wizard by the Who
Short People by Randy Neuman

Partner Relational Problem

You Don’t Bring Me Flowers by Barbara Streisand and Kris Kristofferson
Knowing Me / Knowing You by Abba
If I Could Turn Back Time by Cher
Love is a Battlefield by Pat Benetar
Thunder Rolls by Garth Brooks
Lyin Eyes by the Eagles

Parent and Child Relationship Problem

Father and Son by Cat Stevens
Cats in the Cradle by Harry Chapin
Leader of the Band by Dan Fogelberg
Magic Man by Heart
Hell is For Children by Pat Benetar
Teach Your Children Well by Crosby Stills and Nash

Identity Crisis

I Wouldn’t Want to be like You by the Alan Parsons Project
Question by the Moody Blues
Losing my Religion by REM
The Logical Song by Supertramp
My Generation by the Who

Examples of When Psychotherapy is Successful

I will Survive by Gloria Gainer
Both Sides Now by Joni Mitchell
What Do You Hear In These Sounds Dar Williams
Troubled Times by Dar Williams
I’m Alright by Kenny Loggins
Walking on Sunshine by Katrina and the Waves
My Heart Will Go On by Celine Dion
Lean on Me by the Beatles
Wind Beneath My Wings by Bette Midler
I’m Free by the Who
The Gambler by Kenny Rogers
Shelter From the Storm by Bob Dylan

Bibliotherapy and Beyond 12/2009: Harville Hendrix

I LOVE Harville Hendrix!  My husband has no need to worry about this, because I’ve actually never met Harville face to face (although I will finally get to meet him this Spring and I can’t wait).   The fact that Dr. Hendrix has been happily married for over 20 years with six grown children could be comforting to my husband as well.   And, of course, as a compulsive reader, my husband is used to the fact that I regularly fall “in-love” with my favorite writers and Dr. Hendrix is no exception.  However, unlike most of the authors I “love”, Dr. Hendrix would certainly have a lot of interesting and insightful things to say about it.  Dr. Hendrix is one of the world’s best selling authors on marriage and relationships.  He even has his own page on Amazon and Wikipedia!  He writes with his wife, Dr. Helen Hunt and they are a true “dream team.”  Their books have been published in 57 languages.  A TV program based on their work has been shown on over 300 PBS stations around the country.    Dr. Hendrix has been featured in many popular magazines and on daytime TV and radio programs.  He has been on the Oprah Winfrey Show 17 times and Oprah chose him in her “Top 20 Moments” list of Unforgettable! Oprah’s Top 20 Shows. 
The fact that Oprah likes him may not enhance his credibility with you but it is certainly something to take notice of.  In fact, much of his success can be attributed to his broad appeal to academics, psychotherapists, and ordinary people looking for a good self-help book to improve their relationships.   I was first introduced to his work in graduate school in the mid 1980s and I have followed his progress and writing ever since.  His most popular book (which is one of the best-selling self-help books of all time) is “Getting the Love You Want: A Guide for Couples.”  This book just celebrated its 20th anniversary in print in 2007.  He followed it up with “Keeping the Love You Find: A Personal Guide” in 1992 and “Giving the Love that Heals: A Guide for Parents” in 1997.  All together Dr. Hendrix and his wife have written 9 books on relationships, including several companion workbooks to the three aforementioned books filled with practical exercises and meditations.   His books describe Imago Therapy, which explains why people are attracted to one another in the first place, why romantic relationships are often fraught with conflict and how we can achieve wholeness and healing through healthy intimacy. According to Dr. Hendrix, the ultimate goal of therapy is ”To surrender the judgmental mind, achieve sustainable connection with others and become loving of others and oneself.”
His books are filled with interesting examples, lively discourse and many practical suggestions and applications of Imago Therapy in everyday life.  These books appeal to many practitioners regardless of therapeutic orientation and his work is consistent with empirically validated treatments.  BCPA is privileged to welcome Dr. Hendrix for our Spring Workshop on March 26, 2010.    If you want to learn more prior to the Spring Workshop, take a look at his website at  Or, just do what I always do and grab any of his wonderful books and dive right in. If it appears that I am just shamelessly promoting BCPA’s next workshop, you may have a point, but in fact, I hope my discussion of Dr. Hendrix and his work will encourage you to learn more about his work and attend our Spring Workshop.   But, most of all, I am delighted by this opportunity to share my enthusiasm for one of the most influential psychologists of our time.

Bibliotherapy and Beyond 6/2010: So Much to Read and So Little Time

So much to read, so little time!  We have paperbacks, hardbacks, ebooks, audiobooks, books on CD or MP3, books for  iPod,  iPad, iPhone, Kindle, Nook and the Sony ereader, magazines, newspapers, as well as emails, blogs and all the other tantalizing material on the internet.   And what about professional reading, journals, newsletters, listserve entries and pamphlets? At any given time, I find myself “reading” several magazines or journals, my book club book, a professional book, an escapist utopian science fiction novel, an audiobook on MP3 in my car and an audiobook on my iPhone.   One or more of these books is usually on my Kindle, which, in my opinion, is the best thing to happen to reading in centuries.  I can put my Kindle down on my nightstand and resume from where I left off on my iPhone while waiting at a restaurant and then pick right back up on my computer at the office.  When I want to read in bed before falling asleep, I grab the Kindle from my nightstand and it knows right where I left off on my computer before leaving the office.  What a miracle of technology!  And I can control the font size to accommodate my less-than-perfect vision.  Changing pages just requires the flick of a finger and the Kindle is lighter than most hardbacks and easier to manage nimbly than most paperbacks.  Apparently it can even read the book to you with its text to speech feature, although I haven’t found any need to experiment with that yet.  An author who is a Facebook friend even suggested putting the Kindle in a zip lock bag to read in the bathtub (and yes, it works great!).  Many self-help books, textbooks and professional books are now available for the Kindle and in other ereader formats, as are some journals, magazines and newspapers.  Another helpful feature with the Kindle is the ability to download the first chapter of a book before actually purchasing it.  I’ve spared myself quite a few duds taking advantage of this feature.  This new technology can help even the busiest among us grab precious snippets of blissful reading when presented with a little spare time, no matter what the location or circumstances. 

Recently, I find particular delight in audio books.  I had eye surgery several years ago and I was unable to spend more than a few minutes reading ordinary written text for months.  For me, reading is as necessary to life as eating so this presented a formidable challenge. I decided I would rise to this challenge by exploring the world of audiobooks and I have been a fan ever since.   I am a member of Audible, an online audiobook club recently purchased by Amazon.  For a basic monthly membership fee of $14.95, I can choose one audiobook each month.  I used to get 2 books for $22.95 but I got backlogged so I dropped down to the basic membership and I just buy extras as I need them.  The quality of audiobooks has dramatically improved in recent years, with professional readers who have delightful accents, lovely voices and excellent diction.  Many audiobooks have unique actors or separate voices for different characters which creates dramatic flair and really enhances the timeless pleasure associated with having someone read to you.

FYI, I have no vested interest in Audible, Kindle or Apple.  I just think they offer wonderful products and services to those who love (or have) to read.  I’ve done a lot of research on these resources, which you can benefit from without having to reinvent the wheel on this issue unless you choose to do so.

I’ve recently listened to several excellent audiobooks, but one in particular was a real stand-out.  For my book club last month, we read a memoir, called “The Kids Are All Right” by Diana Welch, Liz Welch, Amanda Welch and Dan Welch.  These four siblings experienced the death of both parents before they were grown.  At the time of their mother’s death they ranged in age from 8 to 19 years old.  Their parents had not made plans for this eventuality so the children found themselves split up among different families with limited contact with one another and minimal practical or emotional support.  They reconnected as young adults and started sharing memories of their parents and childhood experiences.  To their surprise (but hopefully not ours), they discovered their memories of the same events were wildly different.  So they decided to write about their shared past in a way that would candidly reflect their diverse recollections.  The book recounts the time from their father’s death in a car accident, through their mother’s illness and death from cancer 3.5 years later and the time they were separated from one another.  It’s a raw, honest, poignant account that will touch you deeply.  The siblings abiding love for one another and triumph over adversity is truly inspiring.  I was privileged to have Liz Welch “attend” my May book club meeting via Skype.  I put my laptop on a stand at the head of my dining room table and dialed her up (by prior arrangement, of course).  She was articulate, open, thoughtful, frank and funny.  She had marvelous insight, much of which she admitted had come from a wonderful relationship with an excellent therapist (yay us!).   The discussion that night was one of the best we’ve ever had.  This is no small statement considering my book club has been around for over 20 years and this was not our first meeting with an author in attendance.  I highly recommend this book for fellow psychologists since the opportunity to understand real life events from four separate, insightful, articulate members of the same family is a rare opportunity.  Take advantage of it, you will be glad you did.

Until next time, grab your ebook, audiobook, paperback or hardcover whenever you can, enjoy the summer, and HAPPY READING!    

Follow me on Facebook